Blood test, cholesterol (lipid panel)
Facility: Regional Medical Center
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $870
- Cash Discount Price: $86
- vs. Medicare Baseline: 64.97x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $13.39 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 6497% of the Medicare baseline (a markup of 6397%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medical Associates Health Plan - Tri | $870 | 6497% |
Consumer Guidance & Cost Commentary
For a lipid panel blood test at Regional Medical Center in Manchester, the cash price is $86. This facility, a government-owned Critical Access Hospital, lists a negotiated rate of $870 with Medical Associates Health Plan, which is significantly higher than the cash option. While the facility's rating is 4, patients should note that the cash rate of $86 is often more affordable for those with high-deductible plans, as the insurance negotiated rate of $870 far exceeds the self-pay amount.
The Medicare benchmark for this procedure is $13.39, which serves as the objective baseline for evaluating the facility's pricing. Although the data does not provide specific state or county average comparisons, the stark difference between the Medicare rate of $13.39 and the facility's cash price of $86 suggests that commercial rates may include substantial administrative overhead. To ensure you receive the best possible price, patients are encouraged to request a self-pay or prompt-pay discount before scheduling, as paying upfront can sometimes bypass the higher insurance negotiated rate.